title: Association Between Physician Recommendation for Adolescents to Join a Weight Loss Program and BMI Change.
abstract: OBJECTIVE
  To explore whether reasons for enrollment in a pediatric multidisciplinary weight management program (PMWMP) are associated with subsequent weight loss.
  
  
  METHODS
  A retrospective analysis of obese adolescents (12-18 years old, body mass index [BMI] > 95th percentile) who enrolled in a PMWMP from April 2007 to March 2009, and had BMI measurements at weeks 1 and 12. Reasons for enrollment were obtained from parents' responses to an enrollment questionnaire (which allowed selection of more than one reason). The most common reasons for enrollment were computed. Linear regression was used to explore associations between mean change in BMI and reasons for enrollment, controlling for demographic and anthropometric factors.
  
  
  RESULTS
  Most of the 90 adolescents who met the inclusion criteria were female (70%) and white (57%). Mean age was 14.5 years and mean initial BMI was 42 kg/m(2). The most common reasons for enrolling in the PMWMP were due to concerns about adolescents' physical health (96%), concerns about adolescents' mental health (76%), and because of a physician recommendation (73%). The mean 12-week change in BMI showed a greater decrease for those who enrolled due to a physicians' recommendation versus those who did not (-1.5 vs -0.5 kg/m(2): P < .05). This finding remained significant even when controlling for the covariates of interest.
  
  
  CONCLUSIONS
  A physician's recommendation to join a PMWMP appears to be associated with greater weight loss among obese adolescents than other reasons for enrollment. Further research should explore how physician involvement affects long-term weight loss.
authors.affiliation: Pediatric Comprehensive Weight Management Center, University of Michigan, Ann Arbor, MI, USA.
authors.forename: Susan J
authors.initials: SJ
authors.lastname: Woolford
authors.forename: Bethany J
authors.initials: BJ
authors.lastname: Sallinen
authors.forename: Sarah J
authors.initials: SJ
authors.lastname: Clark
authors.forename: Heidi B
authors.initials: HB
authors.lastname: Iglayreger
authors.forename: Paul M
authors.initials: PM
authors.lastname: Gordon
keywords: adolescents; obesity treatment; outcomes; physician referral